Abstract:
In the U.S., an estimated 1 in 5 adolescents between the ages of 12 and 19 have the disease of obesity. Obesity in adolescents is influenced by a variety of factors that include genetics, socioeconomic and environmental factors. This serious, chronic, progressive and misunderstood disease requires long-term management to prevent the development of weight-related problems like hypertension, dyslipidemia, type 2 diabetes, and many others. It is not a disease of willpower; there are underlying biological and societal mechanisms that impede weight loss in the pediatric population. STEP TEEN investigations have revolutionized pharmacotherapy in adolescents. The recommended dose is once weekly 2.4mg dose of s/c Semaglutide to treat obesity in adults. Medication is done as adjunct to reduced calorie diet and adequate physical activity. RCT were conducted in adolescents 12 to 18 years of age with BMI >95th centile or 85th centile with weight related comorbidity. After 68 weeks BMI reduced by 16.1%, weight loss of 5%. There was remarkable improvement in cardio metabolic risk factors (waist circumference, HbA1C, lipids, liver enzymes like ALT). Semalutide is a GLP-1 receptor agonist, which increases insulins secretion, blood sugar disposal, improving glycaemic control. It inhibits production of glucagon hence reducing glycogenolysis and gluconeogenesis. It decreases appetite and slows down gastric emptying. Most common adverse side effect of the medication are gastrointestinal like nausea, vomiting and diarrhea. Also it is contraindicated in people with personal or family/o medullary thyroid cancer and in patients with MEN syndrome type 2. Most common disadvantage is the cost of the medication and it’s relative shortage in early 2022.
